NPIMap

Organization Active NPI

Advanced Cardiac Anesthesia PLLC

  • Anesthesiology Physician
  • Tempe, AZ
National Provider Identifier
1083397764
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ADVANCED CARDIAC ANESTHESIA PLLC
Practice address
2421 E Southern Ave Ste 7
Tempe, AZ 85282-7612
Phone
(480) 425-2160
Fax
(480) 351-8797
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mohamad Reza Kharrazi, MDNPI 1336139237
Title
Physician
Phone
(480) 425-2160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

2421 E Southern Ave Ste 7
Tempe, AZ 85282-7612

Mailing address

PO Box 41150
Mesa, AZ 85274-1150
Phone (480) 425-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231018003369 AZ Part B Supplier - Clinic/Group Practice 8022463595 Receives reassigned benefits from 18 practitioners
Practice locations: Sun City, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1083397764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41150",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852741150",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 E SOUTHERN AVE STE 7",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827612",
            "telephone_number": "480-425-2160",
            "fax_number": "480-351-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARDIAC ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "KHARRAZI",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-425-2160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.